Kaiser Daily Global Health Policy Report

In The News

“Reproductive and human rights advocates pressed President Obama Wednesday to issue an executive order clearing the path for U.S. foreign aid for post-rape care services — including abortions — in parts of the world reeling from crisis or conflict,” The Hill’s “RegWatch” blog reports. “Federal law dating back to 1973 prohibits the use of U.S. funds to ‘pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortions,'” the blog notes, adding, “The language, called the Helms Amendment, after former Sen. Jesse Helms (R-N.C.), does not, however, bar the use of U.S. aid to pay for abortions in cases of rape, activists from [the Center for Health and Gender Equity (CHANGE)], the Global Fund for Women, and Human Rights Watch contend.” CHANGE “has initiated discussions with officials at the State Department and [USAID], and is requesting meetings with the White House to make the case for an executive order, [CHANGE President Serra Sippel] said,” the blog notes (Goad, 12/11).

“Bipartisan negotiators announced on Tuesday a deal on the U.S. federal budget that — despite modest spending cuts — hopes to end the three-year-long impasse which led to sequestration,” Devex reports. “At this stage and while details of the budget proposal are still being unveiled, … [s]upporters of the bill … seem confident to have eluded the devastating effects that a government shutdown would have meant for the already depleted foreign affairs budget, where foreign aid and USAID programs would have been an easy target for lawmakers trying to save costs” (Santamaria, 12/11). “Passage of the agreement in the House before the chamber recesses on Friday for the year would all but guarantee the same in the Senate, probably next week,” Reuters reports (Lawder et al., 12/11).

“The developed world has committed itself to a scientific and social onslaught on Alzheimer’s disease and other forms of dementia at the G8 Dementia Summit in London,” the Financial Times reports (Cookson, 12/11). “Leading countries set a goal of finding a cure or effective treatment for dementia by 2025 on Wednesday and ministers said the world needed to fight the spread of the memory-robbing condition just as it fought AIDS,” Reuters writes (Hirschler, 12/11). “The G8 said it would ‘develop a coordinated international research action plan’ to target the gaps in research and ways to address them,” according to BBC News. “It also called on the [WHO] to identify dementia as ‘an increasing threat to global health’ and to help countries adapt to the dementia time bomb,” the news agency writes (Gallagher, 12/11).

Speaking at the summit, British Prime Minister David Cameron “declared that discovering a cure or treatment for dementia is ‘within our grasp,'” the Associated Press notes (Cheng, 12/11). “The U.K. government is to double funding for dementia research by 2025 and make available … a scan that can rule out Alzheimer’s disease,” Cameron announced at the summit, adding “he would double funding research from £66 million [$108 million] in 2015 to £122 million [$200 million] in 2025,” The Guardian reports (Siddique, 12/11). The Telegraph provides video footage of U.K. Health Secretary Jeremy Hunt speaking at the event, where he warned “‘we will bankrupt our health care systems’ if we do not face up to the challenge of dementia, stressing the need to improve diagnosis rates” (12/11).

“The number of people killed by malaria has been cut by nearly half in Africa and a slightly lower rate globally, but sustained funding is needed to lower the numbers even more, according to the United Nations health agency, which [on Wednesday] released its annual assessment report on the disease,” the U.N. News Centre reports (12/11). “WHO said in its World Malaria Report 2013 that expanded prevention and control measures helped produce declines in malaria deaths and illness,” Reuters writes, noting, “Of the 3.3 million lives saved, most were in the 10 countries with the highest malaria burden and among children under age five, the group most afflicted by the disease” (Steenhuysen, 12/11). According to the report, “increased political commitment and expanded funding have helped to reduce incidence of malaria by 29 percent globally, and by 31 percent in Africa between 2000 and 2012,” and “mortality rates have been reduced by 45 percent globally and by 49 percent in Africa over the same period,” Xinhua adds (12/11). “But much more needs to be done to eliminate the disease, which last year killed an estimated 627,000 people worldwide, about 483,000 of whom were children under the age of five,” Inter Press Service states (Lobe, 12/11).

“Despite such strides, health officials remain concerned that without increased action, these numbers could begin to slip,” Nature World News writes (Kemsley, 12/11). “Part of what is driving incidence and deaths rates down is additional funding targeted toward increasing access to testing for the parasite responsible for the disease,” according to TIME (Rhodan, 12/11). However, “millions of people continue to lack access to diagnosis and quality-assured treatment, particularly in countries with weak health systems,” the WHO states in a press release (12/11). In addition, “[f]or the second year in a row, WHO noted a dramatic decline in the number of bed nets given out to protect people from the mosquitoes that spread malaria,” according to the Associated Press (Cheng, 12/11). “[T]he WHO said that the progress in preventing malaria deaths has slowed down in the last few years, due to [overall] decreased funding. And funding is expected to be below par for the next two years,” United Press International notes (Baliga, 12/11). “Although malaria deaths have fallen worldwide over the last decade, health leaders warned Wednesday of a small but rising threat in parts of Southeast Asia, where anti-malaria drug resistance is confounding experts,” the Los Angeles Times’ “World Now” blog writes (Clemons, 12/11).

“India’s Supreme Court struck down a 2009 lower court decision to decriminalize homosexual conduct, dealing a blow Wednesday to gay activists who have fought for years for the chance to live openly in India’s deeply conservative society,” the Associated Press reports (George, 12/11). “Known as Section 377, the law has been in the books since India’s colonial-era days,” CNN notes (Singh, 12/11). “The 1861 law, which imposes a 10-year sentence for ‘carnal intercourse against the order of nature with man, woman or animal,’ was ruled unconstitutional in a 2009 decision. But the Supreme Court held that only Parliament had the power to change that law,” the New York Times writes (Harris, 12/11). “Correspondents say although the law has rarely — if ever — been used to prosecute anyone for consensual sex, it has often been used by the police to harass homosexuals,” according to BBC News (Pandey, 12/11). “Civil rights attorneys and gay rights activists expressed shock and anger at the ruling,” the Financial Times writes (Kazmin, 12/11).

“Legal experts say gay rights groups could still appeal the judgment by filing a review petition,” the Wall Street Journal notes (Rana/Mandhana, 12/11). “India’s law minister said Thursday that the government has not abandoned efforts to make homosexuality legal, saying the country must take swift action to challenge a Supreme Court decision banning same-sex relations,” according to the Associated Press/Washington Post (12/12). “But it seems unlikely the government will risk taking a stand on the issue in the short term,” Reuters writes, adding, “General elections are due by next May and the socially conservative Hindu nationalist opposition is already gathering momentum” (Asokan, 12/11). “Gay sex has long been a taboo subject in conservative India, where homophobic tendencies abound and many still regard being gay as a mental illness,” Agence France-Presse notes (12/12). With the ruling, “India will rejoin the more than 70 countries — mainly in Africa, the Middle East and South Asia — where homosexual relations are illegal,” The Guardian adds (Burke, 12/11). The Washington Post provides a map of countries where homosexuality is criminalized (Fisher, 12/11).

“The number of people being diagnosed with cancer in the world each year has leaped to more than 14 million” in 2012, compared with 12.7 million cases in 2008, according to new data released Thursday by the WHO’s International Agency for Research on Cancer (IARC), BBC News reports (Gallagher, 12/12). “The global death toll from cancer rose [from 7.6 million in 2008] to 8.2 million in 2012 with sharp rises in breast cancer as the disease tightened its grip in developing nations struggling to treat an illness driven by Western lifestyles,” Reuters writes. “IARC’s report, called GLOBOCAN 2012, gives the most up-to-date estimates for 28 different types of cancer in 184 countries and offers an overview of the global cancer burden,” the news agency notes, adding, “The IARC report said cancer incidence … has been increasing in most regions of the world, but noted what it said were ‘huge inequalities’ between rich and poor countries” (Kelland, 12/12). “Projections based on the GLOBOCAN 2012 estimates predict a substantive increase to 19.3 million new cancer cases per year by 2025, due to growth and aging of the global population,” an IARC press release (.pdf) states (12/12).

“The [WHO] warns of a ‘ticking time bomb’ as tuberculosis is getting increasingly resistant to antibiotics,” TIME reports. “A rampant misuse of antibiotics has led to the bacteria’s increasing resistance, which has mainly affected China, Russia and India,” the magazine notes (Liljas, 12/12). The agency “estimates almost 500,000 people around the world have a type of TB which is resistant to at least two of the main types of drugs used to treat the disease. But most are not diagnosed and are walking around spreading these more deadly strains,” according to BBC News. “The WHO says the overall number of people developing the disease is falling, but 8.6 million people were diagnosed with TB last year, and more than a million people died from the disease,” the news service adds (Mazumdar, 12/11). Think Progress notes “about 80 percent of the people who have drug-resistant TB are not currently being treated” (Culp-Ressler, 12/11).

“Around one third of the world’s children under the age of five have not had their births registered and do not officially exist, leaving them vulnerable to abuse and neglect, … UNICEF said on Wednesday,” the Thomson Reuters Foundation reports (Batha, 12/11). “Almost 230 million youngsters under the age of five have no birth certificate, which puts them at a disadvantage for procedural matters and leaves them more vulnerable to abuse,” Agence France-Presse writes (12/11). “The associated paperwork is often necessary to secure health care, education, and other basic rights,” The Atlantic notes (Jacobs, 12/11). “The 10 countries with the lowest birth registration levels are: Somalia (three percent), Liberia (four percent), Ethiopia (seven percent), Zambia (14 percent), Chad (16 percent), United Republic of Tanzania (16 percent), Yemen (17 percent), Guinea-Bissau (24 percent), Pakistan (27 percent) and Democratic Republic of the Congo (28 percent),” according to a UNICEF press release (12/11). In its report (.pdf), “UNICEF said it was using innovative approaches to help governments and communities strengthen their civil and birth registration systems,” BBC News writes (12/11).

“Governments in poor countries will increasingly see a portion of the aid they receive based on the proven outcome of donor-funded health projects, under a drive for improved accountability coordinated by the World Bank,” the Financial Times reports. “Norway, the U.K. and other industrialized countries met in Oslo on Wednesday to discuss doubling an existing $500 million trust fund for ‘results-based financing for health’ that has already supported similar projects over the past six years in 31 countries,” the newspaper notes. “Jim Yong Kim, president of the World Bank, said in a statement: ‘Evidence shows that results-based financing has a significant impact — saving lives and expanding access to quality, essential health services for the poorest women and children in developing countries,'” according to the newspaper (Jack, 12/12).

In a joint press release, Norway, the U.K., the World Bank Group, UNICEF, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the GAVI Alliance stated, “Results-Based Financing for Health, or RBF, pays providers or recipients of health services after pre-agreed results have been achieved and independently verified” and “assures donors that their funds are being used as intended and producing the desired results.” According to the press release, “[T]he Health Results Innovation Trust Fund [HRITF], managed by the World Bank, is supporting 36 RBF programs in 31 countries … About 75 percent of HRITF funding supports programs in sub-Saharan Africa, which bears over half the global burden of maternal mortality” (12/11).

“The Global Fund to Fight AIDS, Tuberculosis and Malaria didn’t meet its goal last week of raising $15 billion to support disease programs over the next three years. But that isn’t stopping the Geneva-based organization’s executive director, Mark Dybul, from being ‘cautiously optimistic’ that it will,” the Wall Street Journal’s “Washington Wire” blog reports. At a replenishment meeting last week in Washington, D.C., the Global Fund secured $12 billion in pledges, and “[w]hile that’s short of the ultimate goal, it’s about 30 percent more than the international health financier raised for 2011-2013, Dr. Dybul noted in an interview,” the blog writes. Noting several African nations, including Namibia, Nigeria, and Zimbabwe, made pledges, the blog adds, “The contributions from African nations signal a new type of partnership in which nations that once relied heavily on wealthy donors to pay for their disease-fighting programs are now funding and leading many of those programs themselves, [Dybul] said” (McKay, 12/11).

“A new effort to protect women from rape and help them deliver babies in the aftermath of Typhoon Haiyan in the Philippines remains troubled and inadequate, the United Nations and international aid groups said this week,” the New York Times reports. “The effort, loosely coordinated among more than a dozen developed countries, aid groups and the United Nations, is aimed at assisting 65,000 women deemed at risk of sexual assault and an estimated 1,000 women giving birth a day in regions ravaged by the typhoon in November,” according to the newspaper. “The United States has not pledged any money to [a UNFPA] effort, but Nancy Lindborg, the assistant administrator for democracy, conflict and humanitarian assistance at [USAID], said the agency insisted that programs that are part of its $30 million in disaster aid to the Philippines show that they are incorporating measures to protect women,” the newspaper notes and includes comments from several government and non-profit representatives (Wheaton/Bradsher, 12/10).

“Bristol-Myers Squibb is to share intellectual property rights on an important HIV/AIDS drug in a patent pool designed to make treatments more widely available in poor countries,” Reuters reports. The licensing deal between the Medicines Patent Pool (MPP) and Bristol “will enable generic drug firms around the world to produce affordable versions of atazanavir, [sold] under the brand name Reyataz, and to combine it with other medicines to make treatment easier,” the news agency notes (Hirschler, 12/12). “This is the MPP’s first agreement covering a [WHO]-preferred second-line therapy. The WHO estimates there will be over one million people on second-line treatment by 2016, and many more will need access to these therapies,” according to an MPP press release (12/12).

Editorials and Opinions

“We are living through the greatest improvements in child survival and health in human history, and it is thanks in large part to U.S. poverty-focused development assistance, aka ‘foreign aid,'” Rev. John McCullough, president and CEO of Church World Service, and Rev. David Beckmann, president of Bread for the World, write in a letter to Congress published in The Hill’s “Congress Blog.” They add, “It’s time members of Congress take credit for their support of this unprecedented life-saving success.” They continue, “Our government works with other countries, unilateral organizations, non-governmental organizations and faith-based organizations,” adding, “But the U.S. government’s indispensable funding, influence and leadership launches global initiatives, strengthens local capacity, and coordinates humanitarian strategies across national boundaries.”

“Harmful is the falsehood that poverty-focused foreign assistance is wasted. Improved agriculture, safe water, access to sanitation, primary education, vaccinations, better harvests, and economic growth in of some the world’s most impoverished communities is not wasted aid,” McCullough and Beckmann state. “As you consider the unusual threats to foreign aid funding currently underway in the House of Representatives, we ask each one of you to consider this: 18,000 children still die every day, mostly from preventable disease,” they write, adding, “Don’t stop momentum and roll back historic progress. We will stand with you, as do millions of our members — your constituents.” They conclude, “Our deep appreciation goes to those bipartisan supporters in Congress who have long understood this type of foreign assistance is both a smart thing and the right thing to do” (12/11).

Despite “enormous gains made over the past decade to curb three devastating diseases: AIDS, tuberculosis and malaria … there is still a big gap between what’s been accomplished and what more could be done with sufficient financing,” a New York Times editorial states. The editorial summarizes progress against the diseases, but notes more could be accomplished with additional funding and coordinated efforts. “Pledges by nations to [the Global Fund to Fight AIDS, Tuberculosis and Malaria] have fallen short. It will be shameful if millions of people are left to die while donors look the other way,” the editorial concludes (12/11).

“India’s Supreme Court issued a disgraceful ruling against human rights in reinstating a law that bans gay sex” on Wednesday, when “the court reversed a landmark 2009 decision by the Delhi High Court that decriminalized sex between consenting adults regardless of their gender,” a New York Times editorial states. “At issue is Section 377 of India’s Penal Code barring ‘carnal intercourse against the order of nature,’ a holdover from British colonial law dating back to 1861,” the editorial notes, adding, “India’s crimes bureau stated ominously that it will begin compiling crime statistics under Section 377 as early as next year.” Gay-rights supporters and “[h]uman rights groups, including Human Rights Watch and Amnesty International, roundly condemned the Supreme Court decision,” according to the editorial. “Prime Minister Manmohan Singh now has an opportunity to leave a lasting legacy of progress before his government steps down next spring. His cabinet should act immediately to seek a repeal of Section 377,” the editorial concludes (12/11).

Ray Chambers, Huffington Post’s “Impact” blog: “The big headline is that the fight against malaria has reduced by 50 percent the rate of children dying from malaria, and has saved more than 3.3 million lives since 2000,” Chambers, the U.N. special envoy for health financing, writes. “With all this good news also comes a word of warning,” he continues, noting, “The report documents that financial shortfalls in malaria intervention during 2011 and 2012 led to fewer lifesaving commodities reaching in-need communities, and to a notable slowing of malaria progress overall.” He concludes, “As we celebrate, let’s also commit to redoubling our efforts going forward and working for that day when there will be no need for a WHO World Malaria Report” (12/11).

Martin Edlund, CNN: “Much of the progress to date comes from expanded access to simple tools such as insecticide-treated mosquito nets, and we must maintain high levels of coverage,” Edlund, a founding member and CEO of Malaria No More writes. He highlights “three cheap, revolutionary tools” that can help “ultimately eradicate this disease from the planet.” These tools — a rapid diagnostic test, artemisinin-based combination therapies, and mobile phones — “are helping us work faster, smarter and more cost effectively. With their help — and continued investment — we can write malaria into the history books,” he concludes (12/11).

From the Global Health Policy Community

John Kerry, State Department’s “DipNote” blog: The report “confirms what many of us have long believed: we’re knocking on the door of doing what many fifteen years ago deemed impossible. The bottom line: we can beat malaria, one of the most intransigent diseases on the planet,” U.S. Secretary of State Kerry writes. “By bringing together governments, business leaders, philanthropists, donor agencies and citizens in malaria endemic countries to end deaths from this preventable and treatable disease, we’re making tremendous, unparalleled progress,” he states, adding, “The last mile is the toughest and we have to remain committed” (12/11).

Alan Magill, Bill & Melinda Gates Foundation’s “Impatient Optimists” blog: “The report also offers a warning: to truly defeat the disease, we cannot afford to let our guard down,” Magill, director of the Gates Foundation’s malaria program, writes. “Efforts made toward fighting malaria have saved millions of lives, yet malaria remains one of the world’s deadliest killers,” he states, adding, “The foundation is committed to working with partners to expand access to lifesaving prevention and treatment, and to promoting innovative strategies that will accelerate us toward eradication” (12/11).

Noting the Global Fund to Fight AIDS, Tuberculosis and Malaria recently secured $12 billion in new pledges at a replenishment conference, J. Stephen Morrison, senior vice president and director of the Global Health Policy Center at the Center for Strategic and International Studies (CSIS), and Katherine Bliss, a senior associate at the CSIS Global Health Policy Center, write in a publication on the CSIS website, titled “Refueling The Global Fund,” “One clear conclusion emerged: international confidence in the fund has been restored.” They continue, “Beneath the bonhomie however were signals of tough challenges that persist.” Morrison and Bliss describe the prospects for long-term government and private sector support for the Global Fund; the challenge of “achieving substantial ‘country ownership’ by recipient countries”; and the implications of the U.S. Global Fund pledge for PEPFAR (12/11).

The Center for Global Health Policy’s “Science Speaks” blog reports on a Capitol Hill briefing last week that examined “how progress in diagnostic technology is accelerating progress against HIV, TB, malaria, and other emerging infectious diseases.” Noting the briefing was sponsored by CDC and AdvaMedDx, the blog quotes Thomas Kenyon and Beth Bell of the CDC, AdvaMedDx Executive Director Andy Fisher, and Todd Summers of the Center for Strategic and International Studies about the need for advancements in diagnostic technology and highlights the CDC’s goal “to develop an advanced molecular detection program” (Aziz, 12/11).

In a post in the Global Health Technologies Coalition’s “Breakthroughs” blog, the first in “a new blog series to highlight the impact of USAID’s commitment to global health research and development (R&D),” the coalition interviews Ted Prusik, senior vice president of Temptime, “a New Jersey-based company that has made a huge impact in global health with support from USAID.” According to the transcript, Prusik discusses his company’s partnership with USAID, highlights some of the health research successes achieved with USAID’s support, and discusses Temptime’s work with other global health partners, such as PATH, among other topics (Lufkin, 12/11).

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The Kaiser Daily Global Health Policy Report is a free daily publication that provides the latest news and information on global health policy, with a focus on U.S. global health policy and the developments that have important implications for the U.S. global health response.